Staci Lynn Davis, LPC

Individual provider Active NPI Mental Health Counselor · Fulshear, TX

NPI 1023747839 · NPPES record last updated Jun 8, 2022

Key facts

NPI
1023747839
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
75251
Practice address
29142 Crystal Rose LN
Fulshear, TX 77441-1772
Phone
(281) 344-7832
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X 75251 Yes

Addresses

Primary practice location

29142 Crystal Rose LN
Fulshear, TX 77441-1772

Mailing address

29142 Crystal Rose LN
Fulshear, TX 77441-1772
Phone (281) 344-7832

Other providers in Fulshear, TX

All providers in Fulshear, TX · Mental Health Counselor in Texas

Sources for this page

Verify at the official NPI Registry.